How does the EndoPAT® measure endothelial function?
The test will take approximately 20 minutes. You will be asked to lie down for the test and roll up your sleeves. A blood pressure cuff will be wrapped around your arm and fingertip sensors will be placed on both index fingers. Later, the blood pressure cuff will inflate for 5 minutes.
When the blood pressure cuff is inflated, blood flow to the finger will temporarily stop. Later, when the cuff is released, the strong flow of blood stimulates the arteries to dilate and deliver more blood to the finger. Blood flow will be measured by the finger sensor to assess how well the arteries dilate.
Normal response is characterized by a significant dilatoin of the arteries after the blood cuff is released. If arteries fail to dilate sufficiently, the condition is described as Arterial dysfunction (Medical term: Endothelial dysfunction).
Why should I get tested with the EndoPAT®?
Prevention is the best treatment! Cardiovascular disease develops over many years. Initially it is a silent process, often called subclinical atherosclerosis. Endothelial dysfunction is considered to be the hallmark of subclinical atherosclerosis and the earliest clinically detectable stage. Unlike atherosclerosis, endothelial dysfunction is reversible with proper treatment.
What is the endothelium?
The endothelium is the inner lining of blood vessels, allowing blood to flow smoothly within them and actively maintains physiological condition. Normal endothelial function protects blood vessels from formation of atherosclerosis, the cause of cardiovascular disease.
The pathological state known as endothelial dysfunction is the earliest clinically detectable stage of cardiovascular disease (which includes heart attacks, stroke, Peripheral Arterial Disease and many other diseases). The functioning of the endothelial cells – endothelial function – is normally kept in balance. Atherosclerosis risk factors such as high cholesterol, high blood sugar, high blood pressure, smoking, aging, obesity, chronic infection, and inflammation, can all disrupt this balance and lead to endothelial dysfunction.
What is endothelial dysfunction?
Endothelial dysfunction can be defined as reduced bio-availability of Nitric Oxide (NO) which plays many roles in maintaining vascular health, most importantly its role in vasomotion. Hence, endothelial dysfunction is defined as an impairment of endothelium dependent vasodilation. In their 2005 Circulation publication, Lerman et al. (1) defined endothelial dysfunction as “ultimate risk of the risk factors” a summation of the integrated affects of cardiovascular risk factor.
(1) Lerman A and Zeiher A. Endothelial Function, Cardiac events, Circulation 2005, 111,363-368.
What are the consequences of endothelial dysfunction?
The main consequence of endothelial dysfunction is the initiation of an inflammatory process which leads to the formation of atherosclerosis and its late sequel, cardiovascular morbidity and mortality. Endothelial dysfunction is involved in numerous systemic disease processes such as: erectile dysfunction, metabolic syndrome, cerebrovascular diseases (stroke/TIA), pre-eclampsia toxemia, renal failure, sleep apnea, claudication, and gangrene.
What is the PAT signal?
The PAT (Peripheral Arterial Tone) signal is a proprietary technology used for non-invasively measuring arterial tone changes in peripheral arterial beds. The PAT signal used in the EndoPAT® is measured from the fingertip by recording finger arterial pulsatile volume changes. Results of the 15-minute test are automatically calculated and an EndoScore is generated, which indicates the present state of endothelial health.
EndoPAT® is the only FDA-cleared device indicated for assessment of Endothelial Function. Clearance was obtained by demonstrating equivalence of PAT Technology with an invasive catheterization procedure that directly assessed endothelial dysfunction in coronary arteries. The clinical research was conducted at the Mayo Clinic.
What is the EndoPAT®?
The EndoPAT® is the leading medical device for noninvasive endothelial function assessment. It was developed and is distributed by Itamar Medical, Caesarea, Israel.
How is endothelial dysfunction treated?
Arterial dysfunction (Endothelial dysfunction) is treatable and even reversible. Many existing therapies have been clinically proven including lifestyle modification (nutrition and exercise), dietary supplements (such as L-Arginine), drugs (e.g. statins to lower high cholesterol, ACE inhibitors used to treat high blood pressure, PDE-5 inhibitors used to treat erectile dysfunction) and treatment of co-morbidities (e.g. glycemic control for diabetics). New agents that treat endothelial dysfunction specifically are under development.